Ch. 11 & 12 socio of health

Why is it problematic that doctors tend to rely on clinical knowledge rather than scientific research?

Clinical knowledge is based on accumulated experience and it is often wrong

what type of inst. would get involved if you are wanting to get genetic testing to see if your child will have down syndrome or breast cancer in your fam?

Community advisory boards

Which of the following is true?

Low risk population home birth, with low risk populations, home birth conducted by experienced lay midwives is as safe as doctor-attended hospital births

The federal government acquired a big stake in controlling health care costs following the implementation of

Medicaid and Medicare.

In the early 20th century, which of the following was most important in how allopathic physicians came to dominate treatment of disease and illness? [Select all that are TRUE.]

ONLY THIS ONE: political power that pushed other forms of treatment out, legal and political action against other forms of treatment

Which of the following helped doctors gain control over childbirth in the early twentieth century?

Widespread prejudice against immigrants, women, and non-whites.

To gain professional status, osteopaths...

adjust their ed requirements to be more like allopaths & increase ed requirements to become osteopath

Which of the following have the highest status and the most autonomy on the job?

advanced practice nurses

Another term for "regular doctors" is

allopaths.

How were kidney dialysis first given out? (as supply was low and demand was high)

based on social class, emotional stability, marital status

A doc who strongly believes in the core medical values described in the textbook would be most likely to

become a surgeon

Graduating medical students

can expect an average debt greater than $150,000.

Which of the following meets the sociological definition of a profession?

chiropractic

Why is it problematic that docs tend to rely on clinical knowledge rather than scientific research

clinical knowledge is based on accumulated experience and is often wrong

The professional dominance of doctors has declined in part because of

diminished trust in doctors

Over the years, chiropractors have......

improved their status by increasing educational standards for entry into the field.

To gain professional status, osetopaths ..... ?

increased ed requirements & adjusted ed to be more like allopaths

The American Medical Association

is less powerful than the combined countervailing powers in health care.

A treatment is an alternative health care treatment if ........

it starts out from a different point of view about the body and how it work than that which is used by allopathic medicine

Optometrists have obtained considerable social status by limiting their treatments to only one part of the body. This suggests that optometry is a

limited but not marginal occupation.

Sociologists consider nurses semi-professionals, rather than professionals, because

nurses have a lot of autonomy and training, but are subordinate to doctors.

In the dynamic of what is often called "the doctor/nurse game," we can see that..... [Hint: only one of these statements is TRUE and that statement is the one to pick]

nurses often have insights about patients and treatments that doctors don't have, but the nurse has to pretend that any good idea is the doctor's idea

In the early twentieth century,

nursing schools regarded student nurses as a cheap source of labor.

which of the following is a parallel profession?

osteopaths

According to Eliot Freidson and other sociologists, doctors' power over their patients increases when

patients are physically unable to communicate.

Which of the following occupations has benefited most from the rise of managed care?

pharmacists

In the early 20th century, which of the following was most important in how allopathic physicians came to dominate treatment of disease and illness?

political power that pushed other forms of treatment out, legal and political action against other forms of treatment

Published guidelines that establish norms of care for particular medical conditions based on a review of clinical research are known as

practice protocols.

Curanderos

typically train through apprenticeships.

which of the following meets the sociological definition of a profession

(none of the above) (nursing, midwifery, chiropractic, acupuncturist )

Problems with the DRG system, doctors sometimes say they only have two choices

1 - to misreport a patients diagnosis so they can justify a more expensive treatment 2-to ignore their own clinical judgement to change the patients plan to stay within the DRG limits

3 things that define a profession/professionalism

1) set its own educational & licensing standards and to police members for incompetence 2) specialized/technical knowledge 3)autonomy

How are stem cells grown? or harvested?

2 way: 1 scientists can grow stem cells in a lab after harvesting them from adults or fetal blood left in a woman's circulatory system after birth. NO ETHICAL ISSUES HAVE BEEN RAISED WITH THESE 2 WAYS 2 scientist can grow stem cells from embryos, to do so researchers fetilize human eggs w. sperm in a lab to turn them into embryos, leave embryo for a week until it has grown into 100 cells then extract their stem cells (thus, destroying embryos) - THIS FORM IS A FORM OF CLONING as embryo will be genetically identical to the donor. MANY OPPONENTS OF THIS TYPE OF RESEARCH, as "it's killing human life" worrisome because political opposition to stem cell research has shifted it to the for-profit sector where it escapes regulation

Why was the DRG system established? and what did it signify?

Established to set financial limits for each diagnosis as the govt pays for hospital bills of medicaid and medicare patients. Signifies the rise of government control

T or F: During the Nuremburg Trials the discussion of bioethics was increasingly popular

F, bioethics wasn't a topic of popular debate in the U.S. until the 60s-70s with the rise of technology

T or F: Americans regarded the experiments done by the Nazi's with much respect

F, they viewed them as Nazis

Resource Allocation and the right to refuse to treat- how do we decide in the U.S. who gets treatment and resources to surgical care/drugs/treatments?

If you can pay for it, you can get it

T or F : Doctors have worked to strip acupuncture of its grounding in traditional Chinese medical philosophy.

T

T or F: bioethnics were virtually nonexistent before the 60s

T, the growth the bioethics movement has grown to hospitals & colleges now more visible than ever. Before the 60s it wasn't talked about

What does the dialysis debate focus on?

The right to gain access to life saving technologies, "the right to die"

What category do these issues fall into (stem cell research, resource allocation & right to refuse treatment, cosmetic surgery, concussion)

contemporary bioethical issues

since the 70s, ________________ and the resulting emphasis on cost control have resulted in worse working conditions and decreased job satisfaction for most hospital based nurses

corporatization

By the 1900s the status of allopathic medicine had improved. Americans increasingly respected this kind of doctor because they.........

defined healthcare as a complex matter that requiring expert intervention

The US government developed a strategy to attempt to control health care costs that involved setting an average length of hospital stay and costs for in-patient treatment. The key element of this system was:

diagnostic related groups DRGs

Those who support practice protocols are likely also to support

evidence-based medicine.

Homeopathic doctors treated illness with

extremely diluted solutions of drugs.

What types of incidents do the inst. review boards handle?

federally funded research projects w. human subjects. To counter them big pharma instilled commerical IRBS to get drugs approved

Parents' decisions against vaccinating their children

have led to outbreaks of measles in the United States.

What type of inst. bioethics committee would decide if a woman can get abortions or not

hospital ethnics committee

The growth of clinical pharmacy has got a lot of support from _________________

hospitals use of pharmacists to deliver patients medications, hospitals fear of legal liability for medication errors

What does the history of pharmacy illustrate ?

how corporatization can limit an occupation's ability to retain crucial professional prerogatives

Chiropractic medicine's history illustrates

how despite medical dominance, an alt health care occupation can secure a role for itself primarily by limiting it's services to a narrow field

dentist, chiropractor, optometrist, podriatrist can all be categorized as?

limited practitioners

The history of osteopathy suggests how difficult it is to

maintain an independent and unique identity while becoming a parallel profession.

What happened after the Flexner Report -

monopolized medical education, changes in science and medical education

the process through which medical students learn the skills, knowledge and value of medicine as an occupation is referred to as

professional socialization

The process through which medical students learn the skills, knowledge, and values of medicine as an occupation is referred to as

professional socialization.

During most of the nineteenth century, allopathic doctors typically

received less than one year of training

to become a professional in an occupation a occupation must ________

set its own education & licensing standards

To become a profession, an occupation must

set its own education and licensing standards.

Men who enter nursing

tend to be promoted very rapidly

What did Karen Quinlan's case highlight to American society?

the "right to die", refusal of medical technologies from feeding tubes or heart machines. Also signaled entry of lawyers in the legal system of healthcare making problems left up to the courts to decide should medical issues

In the early twentieth century, those nurses who fought to raise the status of nursing were hampered by.... [select all that are TRUE]

the ethic of caring and duty, ideas about women's proper role and character, women's lack of political power.

RBRVS (resource-based relative value scale) was adopted to increase

the incomes of doctors in primary practice.

According to sociological analysts, doctors have lost professional dominance because of...

the insurance companies' power

Compared to conditions in the 1900s by the late 1920s

the quality of medical training had improved considerably

Compared to modern direct-entry midwives, physicians more often

use unnecessary and potentially dangerous drugs and surgeries

Medical culture stresses that doctors should

value clinical experience more than scientific knowledge.

are pharmacist professionals?

yes, but find their autonomy constrained